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Medicaid Drug Ulilization Review (DUR) Annual Report (42 CFR 456.712 and 438.3)
 
No Modified
 
Mandatory
 
42 CFR 456.712

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-R-153 Yes Yes Fillable Printable
Form CMS-R-153 Yes Yes Fillable Fileable
Form CMS-R-153 Yes Yes Fillable Fileable

Health Health Care Services

 

51 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 51 0 0 0 0 51
Annual IC Time Burden (Hours) 3,264 0 0 0 0 3,264
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
FFS Annual Report - Track Changes 09/26/2019
MCO Annual Report - Track Changes 09/26/2019
Crosswalk 09/26/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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